Tselikas Lambros, Joskin Julien, Roquet Florian, Farouil Geoffroy, Dreuil Serge, Hakimé Antoine, Teriitehau Christophe, Auperin Anne, de Baere Thierry, Deschamps Frederic
Interventional Radiology Department, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France,
Cardiovasc Intervent Radiol. 2015 Feb;38(1):167-76. doi: 10.1007/s00270-014-0870-9. Epub 2014 Mar 14.
This study was designed to compare the accuracy of targeting and the radiation dose of bone biopsies performed either under fluoroscopic guidance using a cone-beam CT with real-time 3D image fusion software (FP-CBCT-guidance) or under conventional computed tomography guidance (CT-guidance).
Sixty-eight consecutive patients with a bone lesion were prospectively included. The bone biopsies were scheduled under FP-CBCT-guidance or under CT-guidance according to operating room availability. Thirty-four patients underwent a bone biopsy under FP-CBCT and 34 under CT-guidance. We prospectively compared the two guidance modalities for their technical success, accuracy, puncture time, and pathological success rate. Patient and physician radiation doses also were compared.
All biopsies were technically successful, with both guidance modalities. Accuracy was significantly better using FP-CBCT-guidance (3 and 5 mm respectively: p = 0.003). There was no significant difference in puncture time (32 and 31 min respectively, p = 0.51) nor in pathological results (88 and 88 % of pathological success respectively, p = 1). Patient radiation doses were significantly lower with FP-CBCT (45 vs. 136 mSv, p < 0.0001). The percentage of operators who received a dose higher than 0.001 mSv (dosimeter detection dose threshold) was lower with FP-CBCT than CT-guidance (27 vs. 59 %, p = 0.01).
FP-CBCT-guidance for bone biopsy is accurate and reduces patient and operator radiation doses compared with CT-guidance.
本研究旨在比较在使用带有实时三维图像融合软件的锥形束CT的荧光透视引导下（FP-CBCT引导）或在传统计算机断层扫描引导下（CT引导）进行骨活检时的靶向准确性和辐射剂量。
前瞻性纳入68例连续的骨病变患者。根据手术室的可用性，在FP-CBCT引导或CT引导下安排骨活检。34例患者在FP-CBCT引导下进行骨活检，34例在CT引导下进行。我们前瞻性地比较了两种引导方式在技术成功率、准确性、穿刺时间和病理成功率方面的差异。还比较了患者和医生的辐射剂量。
两种引导方式下所有活检在技术上均获成功。使用FP-CBCT引导时准确性明显更高（分别为3毫米和5毫米：p = 0.003）。穿刺时间无显著差异（分别为32分钟和31分钟，p = 0.51），病理结果也无显著差异（病理成功率分别为88%和88%，p = 1）。FP-CBCT引导下患者的辐射剂量显著更低（45 mSv对136 mSv，p < 0.0001）。接受高于0.001 mSv剂量（剂量计检测剂量阈值）的操作人员百分比，FP-CBCT引导低于CT引导（27%对59%，p = 0.01）。
与CT引导相比，FP-CBCT引导用于骨活检准确且可降低患者和操作人员的辐射剂量。
